白内障超声乳化吸除术前后黄斑区厚度变化的OCT观察

Macular thickness changes before and after phacoemulsification by optical coherence tomography

目的：观察白内障超声乳化联合人工晶状体植入术对白内障患者黄斑中心凹视网膜厚度变化的影响。方法：将60例白内障患者的手术眼作为手术组,对侧眼作为对照组,两组术前、术中无并发症,术前和术后1wk;1,3,6mo黄斑区行OCT测量,观察两组术后黄斑中心凹视网膜厚度变化。结果：手术组：术后1wk和1,3mo黄斑中心凹视网膜厚度与术前相比,均有统计学差异（P〈0.05）,术后6mo黄斑中心凹视网膜厚度与术前相比,无统计学差异（P〉0.05）,术后1mo黄斑中心凹视网膜厚度明显高于其他组（P〈0.05）。其中12眼术后出现黄斑水肿,均发生于术后2-4wk,包括10眼中心凹增厚及2眼黄斑囊样水肿,其中11眼于6mo内自愈。对照组：术前黄斑中心凹视网膜厚度与术后1wk;1,3,6mo相比,均无统计学差异（P〉0.05）。手术组与对照组：两组术前、术后6mo黄斑中心凹视网膜厚度对比,均无统计学差异（P〉0.05）,两组术后1wk和1,3mo黄斑中心凹视网膜厚度对比,均有统计学差异（P〈0.05）。结论：白内障超声乳化联合人工晶状体植入术后黄斑中心凹视网膜厚度显著增加,少数患者会出现黄斑水肿,但绝大多数患者可自愈,预后良好。

AIM ： To observe the influence of phacoemulsification combined with intraocular lens implantation on retinal thickness changes of macular center fovea using optical coherence tomography（ OCT） in cataract patients. METHODS： Surgical eyes of 60 cases with cataract were as surgery group,the contralateral eye were as controls group. There was no complication before and during the surgery. Macular thickness was examined by OCT preoperatively and 1w k, 1, 3, and 6m o after surgery. The retinal thickness changes of macular center foveawere compared after surgery. The SPSS 17. 0softw are was used for statistical analysis. The paired t-test and variance analysis were used in two groups before and after surgery for relevant statistical data analysis（ α = 0. 05）. RESULTS： In surgery group, the retinal thickness changes of macular center fovea at 1w k,1,3mo after treatment had significant differences compared with preoperation（ P〈0. 05）. The retinal thickness changes of m acular center fovea at 6mo after treatment had no statistical significance com pared with preoperation（ P〉0. 05）. The retinal thickness changes of m acular center fovea was significantly higher than other groups at 1mo after treatment（ P〈0. 05）. The center fovea appeared tobe abnormally thickened in 12 eyes,including 10 eyes of single fovea thickening and 2 eyes of cystoid m acular edem a in 2 - 4wk following surgery. Eleven eyes of them w ere resolved till 6m o postoperatively. In control group,preoperation or after operation for 1w k,1,3,and 6mo respectively,P values were without statistical differences（ P〉0. 05）. There were no statistical significant differences on retinal thickness of macular center fovea betw een two groups before and 6mo after surgery（ P〈0. 05）,while there w ere significant differences at 1w k,1and 3m o after surgery（ P〈0. 05）CONCLUSION： The retinal thickness changes of m acular center fovea increases significantly after phacoem ulsification combined with intraocular lens im plantation. In a few of cases appear macular edem a,but the majority of patients can be restored,prognosis is good.